Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre
<b>Background:</b> Antimalarial agents (AMAs) are cornerstone drugs in the treatment of systemic lupus erythematosus (SLE), and their use has established benefits, such as improved prognosis and decelerated accrual of organ damage. The aim of this study was to investigate the frequency o...
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/5/1485 |
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| author | Tomas Walhelm Lina Wirestam Yvonne Enman Ioannis Parodis Christopher Sjöwall |
| author_facet | Tomas Walhelm Lina Wirestam Yvonne Enman Ioannis Parodis Christopher Sjöwall |
| author_sort | Tomas Walhelm |
| collection | DOAJ |
| description | <b>Background:</b> Antimalarial agents (AMAs) are cornerstone drugs in the treatment of systemic lupus erythematosus (SLE), and their use has established benefits, such as improved prognosis and decelerated accrual of organ damage. The aim of this study was to investigate the frequency of discontinuation of AMAs and associated factors in a Swedish SLE population. <b>Methods:</b> We retrieved data from a regional SLE register where all patients fulfilled the 1982 ACR and/or the 2012 SLICC classification criteria. A total of 328 subjects were included in the analysis. <b>Results:</b> Altogether, 92.4% (303/328) had been prescribed AMAs at some point during their disease. At the last available visit, 67.7% (222/328) were currently prescribed AMAs. Among individuals who had discontinued use, 24.7% (20/81) had developed a contraindication. Side effects were also common reasons for discontinuation (<i>n</i> = 38); gastrointestinal symptoms (52.6%, 20/38) were most common. Patients who discontinued had accrued more organ damage at the last visit (mean SDI: 2.9; SD: 2.8) compared with those still on AMAs (mean SDI: 1.4; SD: 1.8; <i>p</i> = 0.001). <b>Conclusions:</b> Most patients had been exposed to AMAs, but 25% discontinued therapy. Among side effects leading to discontinuation, >50% were gastrointestinal, calling for adequate gastroprotection towards drug retention and prevention of organ damage progression. |
| first_indexed | 2024-04-25T00:27:06Z |
| format | Article |
| id | doaj.art-cfd9a840870e43f3824437be0186c77b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-25T00:27:06Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cfd9a840870e43f3824437be0186c77b2024-03-12T16:48:38ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01135148510.3390/jcm13051485Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral CentreTomas Walhelm0Lina Wirestam1Yvonne Enman2Ioannis Parodis3Christopher Sjöwall4Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, SwedenDivision of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, SwedenDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet, SE-171 77 Stockholm, SwedenDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet, SE-171 77 Stockholm, SwedenDivision of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden<b>Background:</b> Antimalarial agents (AMAs) are cornerstone drugs in the treatment of systemic lupus erythematosus (SLE), and their use has established benefits, such as improved prognosis and decelerated accrual of organ damage. The aim of this study was to investigate the frequency of discontinuation of AMAs and associated factors in a Swedish SLE population. <b>Methods:</b> We retrieved data from a regional SLE register where all patients fulfilled the 1982 ACR and/or the 2012 SLICC classification criteria. A total of 328 subjects were included in the analysis. <b>Results:</b> Altogether, 92.4% (303/328) had been prescribed AMAs at some point during their disease. At the last available visit, 67.7% (222/328) were currently prescribed AMAs. Among individuals who had discontinued use, 24.7% (20/81) had developed a contraindication. Side effects were also common reasons for discontinuation (<i>n</i> = 38); gastrointestinal symptoms (52.6%, 20/38) were most common. Patients who discontinued had accrued more organ damage at the last visit (mean SDI: 2.9; SD: 2.8) compared with those still on AMAs (mean SDI: 1.4; SD: 1.8; <i>p</i> = 0.001). <b>Conclusions:</b> Most patients had been exposed to AMAs, but 25% discontinued therapy. Among side effects leading to discontinuation, >50% were gastrointestinal, calling for adequate gastroprotection towards drug retention and prevention of organ damage progression.https://www.mdpi.com/2077-0383/13/5/1485systemic lupus erythematosusantimalarialshydroxychloroquinechloroquinedrug survival |
| spellingShingle | Tomas Walhelm Lina Wirestam Yvonne Enman Ioannis Parodis Christopher Sjöwall Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre Journal of Clinical Medicine systemic lupus erythematosus antimalarials hydroxychloroquine chloroquine drug survival |
| title | Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre |
| title_full | Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre |
| title_fullStr | Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre |
| title_full_unstemmed | Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre |
| title_short | Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre |
| title_sort | factors associated with survival and discontinuation of anti malarial agents in systemic lupus erythematosus results from a tertiary swedish referral centre |
| topic | systemic lupus erythematosus antimalarials hydroxychloroquine chloroquine drug survival |
| url | https://www.mdpi.com/2077-0383/13/5/1485 |
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